Does Medicare/Medicaid pay for remote patient monitoring?

Yes. Medicare/Medicaid does pay for remote patient monitoring. According to the Centers for Medicare & Medicaid Services (CMS), the coverage include the following:

CPT #99457 and #99458 provide reimbursement for 20 minutes of interactive communication, both in-person and telehealth, between the provider and the patient over a calendar month

CPT #99091 can have once a month billing for a minimum of 30 minutes for reviewing patient data by doctors or qualified health practitioners only

CPT #99453 includes billing for remote monitoring of physiologic parameters, such as oxygen saturation via pulse oximetry, weight, respiratory flow rate, blood pressure, and its initial setup and training of equipment use. The billing is every 30 days

CPT#99454 includes billing for remote monitoring of physiologic parameters, such as oxygen saturation via pulse oximetry, weight, respiratory flow rate, blood pressure, and the initial supply of devices and daily recordings and programmed alert transmission for 30 days

These are not the only codes that can be used to bill for RPM-type services. For example, there are specific codes for continuous glucose monitoring (95250) and for self-measured blood pressure monitoring (99473 and 99474). When there are more specific codes that can be billed, those should be used instead.

Two of the remote patient monitoring CPT codes are meant to cover practice expense costs including device and supplies costs and clinical staff time to set up and teach patients how to use the devices. The other three remote patient monitoring CPT codes cover clinical staff time for the review of patient data and communication. This includes CPT codes 99457, 99458, and 99091.

RPM codes are considered Evaluation and Management (E/M) services. This means that RPM can only be ordered and billed by physicians or E/M eligible non-physician practitioners.

Please note that these CPT codes can only be billed by a single specialty (practitioner), during a set period of time, even though any specialty is allowed to enroll a patient in a program. Furthermore, the 99453 and 99454 CPT code may only be billed once during the set period of time regardless of the number of devices/parameters being monitored.